A bivariate approach to meta‐analysis

Houwelingen, Hans C. van; Zwinderman, Koos; Stijnen, Theo

doi:10.1002/sim.4780122405

Cited by 289 publications

(255 citation statements)

References 6 publications

Supporting

Mentioning

246

Contrasting

Unclassified

Order By: Relevance

“…[16][17][18] Covariates indicating design features were used to examine whether, on average, studies that failed to meet certain methodologic criteria yielded different estimates of accuracy. The diagnostic odds ratio (DOR) was used as the summary measure of diagnostic accuracy.…”

Section: Resultsmentioning

confidence: 99%

Evidence of bias and variation in diagnostic accuracy studies

Rutjes

Reitsma

Nisio

et al. 2006

CMAJ

508

389

View full text Add to dashboard Cite

A lthough the number of test evaluations in the literature is increasing, much remains to be desired in terms of methodology. A series of surveys have shown that only a small number of studies of diagnostic accuracy fulfil essential methodologic standards. 1-3Shortcomings in the design of clinical trials are known to affect results. The biasing effects of inadequate randomization procedures and differential dropout have been discussed and demonstrated in several publications.4-6 A growing understanding of the potential sources of bias and variation has led to the development of guidelines to help researchers and readers in the reporting and appraisal of results from randomized trials.7,8 More recently, similar guidelines have been published to assess the quality of reporting and design of studies evaluating the diagnostic accuracy of tests. For many of the items in these guidelines, there is no or limited empirical evidence available on their potential for bias. 9In principle, such evidence can be collected by comparing studies that have design deficiencies with studies of the same test that have no such imperfections. Several large metaanalyses have used a meta-regression approach to account for differences in study design.10-12 Lijmer and colleagues examined a number of published meta-analyses and showed that studies that involved nonrepresentative patients or that used different reference standards tended to overestimate the diagnostic performance of a test.13 They looked at the influence of 6 methodologic criteria and 3 reporting features on the estimates of diagnostic accuracy in a limited number of clinical problems.We conducted this study of a larger and broader set of meta-analyses of diagnostic accuracy to determine the relative importance of 15 design features on estimates of diagnostic accuracy. Methods Data sources: systematic reviewsAn electronic search strategy was developed to identify all systematic reviews of studies evaluating the diagnostic accuracy of tests that were published between January 1999 and April 2002 in MEDLINE (OVID and PubMed), EMBASE (OVID), the Database of Abstracts of Reviews of Effect (DARE) of the Centre for Reviews and Dissemination (www.york.ac.uk/inst/crd Evidence of bias and variation in diagnostic accuracy studiesBackground: Studies with methodologic shortcomings can overestimate the accuracy of a medical test. We sought to determine and compare the direction and magnitude of the effects of a number of potential sources of bias and variation in studies on estimates of diagnostic accuracy. Methods:We identified meta-analyses of the diagnostic accuracy of tests through an electronic search of the databases MEDLINE, EMBASE, DARE and MEDION (1999-2002). We included meta-analyses with at least 10 primary studies without preselection based on design features. Pairs of reviewers independently extracted study characteristics and original data from the primary studies. We used a multivariable metaepidemiologic regression model to investigate the direction and strength of the a...

show abstract

Section: Resultsmentioning

confidence: 99%

Evidence of bias and variation in diagnostic accuracy studies

Rutjes

Reitsma

Nisio

et al. 2006

CMAJ

508

389

View full text Add to dashboard Cite

show abstract

“…These factors make it difficult for workers in this field to know the exact value of the two approaches. Meta-analysis represents a powerful tool to summarize findings in the literature by taking into consideration and enabling analysis of differences between studies [19,20]. Thus, the purpose of our study is to perform a systematic review to compare the anterior surgery with the posterior surgery for MCM by comparing the surgical outcomes, radiographic changes and complications of these two approaches.…”

Section: Introductionmentioning

confidence: 99%

Anterior versus posterior surgery for multilevel cervical myelopathy, which one is better? A systematic review

Liu

Cheng

et al. 2010

Eur Spine J

View full text Add to dashboard Cite

The objective of the study is to perform a systematic review to compare the clinical outcomes and complications of anterior surgery with posterior surgery for multilevel cervical myelopathy (MCM). MEDLINE, EM-BASE databases and other databases were searched for all the relevant original articles published from January 1991 to November 2009 comparing anterior with posterior surgery for MCM. Subgroup analysis was performed according to the follow-up years. The following end points were mainly evaluated: final follow-up JOA (Japanese Orthopaedic Association) scale, recovery rate and complication outcomes. Ten articles fulfilled all inclusion criteria. For multilevel CSM patients, the final follow-up JOA score for the anterior group was significantly higher than the posterior group (p \ 0.05, WMD 0.83 [0.24, 1.43] [31] which mean follow-up time was 6 years was enrolled in the 'follow-up time [5 years' subgroup. The results showed there was no significant difference in final follow-up JOA score and recovery rate between anterior and posterior group for patients with occupying ratio of OPLL \60% (p [ 0.05), while in patients with occupying ratio C60%, the final follow-up JOA score and recovery rate of anterior surgery were both superior to that of posterior surgery (p \ 0.05). For both multilevel CSM and OPLL patients, the complications for the anterior group were significantly more than the posterior group in the 'follow-up time B5 years' subgroup (p \ 0. 05, OR 7.33 [2.96, 18.20 (2011( ) 20:224-235 DOI 10.1007( /s00586-010-1486 OPLL patients with occupying ratio C60%, anterior surgery had superior clinical outcome to posterior surgery.Eur Spine J

show abstract

“…In our meta-analysis, the pooled sensitivity, specificity, PLR, NLR, and DOR were calculated using the bivariate mixed-effects regression model developed by van Houwelingen and modified for evaluating diagnostic test data [32,33]. The area under the ROC curve (AUROC) was between 0.5 and 1.0.…”

Section: Discussionmentioning

confidence: 99%

Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis

et al. 2017

View full text Add to dashboard Cite

Aim: To investigate the clinical utility of shear wave elastography (SWE) imaging in the identification of malignant and benign lesions of the liver lesions by conducting a meta-analysis. Material and methods: The Cochrane library, Embase and Pubmed were searched for relevant studies with publication data through February 2016. Studies evaluating the diagnostic accuracy of SWE in the identification of malignant and benign lesions of the liver using SWE technology were selected. The cytology, histology or clinical imaging was used as the reference standard. The pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under hierarchical summary receiver operating characteristic curve (HSROC) were used to examine the diagnostic accuracy. Results: A total of 9 cohort studies involving 1046 liver lesions (malignant 679) from 968 patients were identified. All of the 9 studies were prospective studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of SWE in differentiating malignant and benign liver lesions were 82.2% (95% CI: 73.4–88.5), 80.2% (95% CI: 73.3–85.7), 4.159 (95% CI: 2.899–5.966), 0.222 (95% CI: 0.140–0.352), and 18.749 (95% CI: 8.746–40.195), respectively. The area under the HSROC curve was 87% (95% CI: 84–90). Conclusions: This meta-analysis indicates that SWE is useful in evaluating the stiffness of liver lesions and in differentiating between malignant and benign lesions. Due to the high sensitivity, specificity, and diagnostic odds ratio, SWE can be considered as a useful complement to conventional ultrasonography.

show abstract

A bivariate approach to meta‐analysis

Cited by 289 publications

References 6 publications

Evidence of bias and variation in diagnostic accuracy studies

Evidence of bias and variation in diagnostic accuracy studies

Anterior versus posterior surgery for multilevel cervical myelopathy, which one is better? A systematic review

Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis

Contact Info

Product

Resources

About